Motor Cortex Stimulation for Neuropathic Pain: A Randomized Cross-over Trial

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
Julia A E RadicRobert M Brownstone

Abstract

Chronic motor cortex stimulation (MCS) has been used to treat medically refractory neuropathic pain over the past 20 years. We investigated this procedure using a prospective multicentre randomized blinded crossover trial. Twelve subjects with three different neuropathic pain syndromes had placement of MCS systems after which they were randomized to receive low ("subtherapeutic") or high ("therapeutic") stimulation for 12 weeks, followed by a crossover to the other treatment group for 12 weeks. The primary outcome measure was the pain visual analogue scale (VAS). Secondary outcome measures included McGill Pain Questionnaire (MPQ), Beck Depression Inventory-II, medication log, work status, global impression of change, and SF-36 quality of life scale. The trial was halted early due to lack of efficacy. One subject withdrew early due to protocol violation and five subjects withdrew early due to transient adverse events. Six subjects with upper extremity pain completed the study. There was no significant change in VAS with low or high stimulation and no significant improvement in any of the outcome measures from low to high stimulation. SF-36 role physical and mental health scores were worse with high compared to low stimulation (p...Continue Reading

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Citations

Feb 24, 2016·Frontiers in Neuroscience·Marcos F DosSantosAlexandre F DaSilva
Jul 15, 2016·Computational and Structural Biotechnology Journal·C Michael HoneyChristopher R Honey
May 20, 2017·Neuromodulation : Journal of the International Neuromodulation Society·Zurab IvanishviliChristopher R Honey
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Jun 2, 2021·Lancet·Helena KnotkovaMarc A Huntoon
Aug 11, 2021·Brain : a Journal of Neurology·Clement HamaniDaniel Ciampi de Andrade

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